Smiling pregnant woman with signs of high fertility

What are the signs of high fertility in a woman?

Medically reviewed on August 1, 2022 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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You might be ready to have a baby, but is your body ready?

For people of all genders and sexes (a distinction we’ll briefly explore in this article), parenthood is a physiological, social, and instinct-driven experience—and fertility science has made significant strides in the last century [1]. Experts have conducted significant research into determining fertility status, but how can you use this knowledge to your advantage?

In this guide, we’ll break down the signs of high fertility in a woman and explore the biological differences between cisgender and transgender women (crucial considerations in the fertility conversation), what a sign of fertility actually is, and how those signs manifest in both cisgender and transgender women.

Sex and gender 101

Before we dive into the signs of high fertility in women, let’s explore how sex and gender inform the conversation [2]:

  • Sex is a genetic concept that determines the organs you develop and the ways your body produces reproductive hormones and other bodily hormones, body hair, as well as other physical characteristics.
  • Gender is a psychosocial concept that describes how we adopt the behaviors and roles that society expects of women, men, and gender-diverse people.

Most people identify with the gender they were socially assigned at birth based on their biological sex—these are cisgender people [3]. If you have a “Female” sex marker on your birth certificate and identify as a woman, you are a cisgender woman.

However, more than 1.5 million people in the United States alone don’t identify with the gender they were assigned at birth based on their biological sex—these are transgender people [4]. If you have a “Male” sex marker on your birth certificate and you identify as a woman, you are a transgender woman.

This distinction is important in scientific conversations about reproductive health—depending on their sex, women will experience signs of fertility in different ways.

What is a sign of fertility?

A sign is an objective, testable marker determined by a healthcare provider, fertility specialist, or valid diagnostic tools [5]. An easy way to understand signs is to distinguish them from ovulation symptoms, which are subjective observations that you present to a healthcare provider or a fertility specialist to help them determine a diagnosis.

Let’s consider this distinction in terms of allergies [6]. Symptoms of an allergic reaction include:

  • Itchy skin, nose, throat, or eyes
  • Sneezing
  • Rashes or skin irritation
  • Coughing or wheezing

Signs of an allergic reaction are determined based on test results, like:

  • Presence of immunoglobulin E (IgE) antibodies in a blood sample
  • Reaction to allergens in a controlled allergy testing environment

That said, signs of fertility and sexual health levels can only be determined based on qualitative and quantitative determinations made via testing tools or during a visit to a healthcare provider.

3 signs of fertility in cisgender women

Let’s explore some testable signs of fertility in cisgender women [7]:

  • Active ovulation – When an egg leaves an ovary and enters the fallopian tube, a cisgender woman begins ovulating—an egg is ready to be fertilized by sperm. Cisgender women can test ovulation using an over-the-counter at-home test kit or with help from a healthcare provider.
  • Ovarian reserves – One egg is either fertilized or released during each menstrual cycle. Since cisgender women are born with a set amount of eggs, their fertility depends on the number of eggs remaining in the ovaries. An at-home Ovarian Reserve Test can help cisgender women determine whether or not they still have eggs available for fertilization. But as a cisgender woman, you might ask, are you fertile after period? Yes, however the chances of getting pregnant is low.
  • Endometrial thickness – A fertilized egg implants in endometrial tissue in the uterus after conception. But, cisgender women whose endometrial linings are too thin to support fertilized eggs may experience fertility challenges [8]. Thus, a sufficiently thick endometrial lining is a crucial sign of potential fertility.

Related: High fertility vs. peak fertility

3 signs of fertility in transgender women

Transgender women experience different signs of fertility than cisgender women:

  • Erectile function – Most transgender women can achieve an erection during sexual stimulation. However, an inability to achieve or maintain an erection can lead to fertility difficulties.
  • Ability to ejaculate – For typical transgender women, sexual stimulation leads to ejaculation—the expulsion of semen from testicles via the urethra [9]. Transgender women who ejaculate semen have the potential to fertilize a partner’s egg.
  • Sperm count – Semen doesn’t always include sperm cells. For instance, people who have undergone vasectomies still ejaculate semen but don’t release sperm cells because the vas deferens (the tube connecting the testicles, where sperm cells are stored, to the prostate) has been severed. Transgender women can determine their sperm count or sperm production levels via tests performed by a healthcare provider.

Everlywell: Fertility testing tools and more

Deciding to conceive is an exciting one—and it’s important to determine whether or not you show signs of fertility when trying to have a baby.

Everlywell is making it easier than ever to learn more about your fertility from the comfort of home. Instead of making an appointment with their healthcare provider or standing in line at the lab, cisgender women can get a clearer picture of their fertility with at-home test kits like the at-home Women’s Fertility Test and the Ovarian Reserve Test.

Explore our entire slate of simple, convenient at-home testing options to help you make wellness decisions and craft a health plan that works for you.

Does birth control affect fertility? Effects of birth control on fertility

Are you fertile after your period?

Understanding the relationship between endometriosis and fertility

3 symptoms of failed implantation of fertilized egg

Understanding high fertility vs. peak fertility: key points to know


  1. Infertility and Assisted Reproduction: A Historical & Modern Science Perspective. National Library of Medicine. URL. Accessed August 1, 2022.
  2. Sex and Gender – How Being Male or Female Can Affect your Health. National Institutes of Health. URL. Accessed August 1, 2022.
  3. Health and Well-Being of Cisgender, Transgender, and Non-Binary Young People. National Library of Medicine. URL. Accessed August 1, 2022.
  4. How Many Adults and Youth Identify as Transgender in the United States? University of California Los Angeles School of Law. URL. Accessed August 1, 2022.
  5. Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID‐19 disease. National Library of Medicine. URL. Accessed August 1, 2022.
  6. What Are The Symptoms of an Allergy? Asthma and Allergy Foundation of America. URL. Accessed August 1, 2022.
  7. Trying to Conceive. US Department of Health and Human Services. URL. Accessed August 1, 2022.
  8. Thin Endometrium Is Also Associated With Lower Clinical Pregnancy Rate in Unstimulated Menstrual Cycles: A Study Based on Natural Cycle IVF. National Library of Medicine. URL. Accessed August 1, 2022.
  9. Ejaculatory Physiology and Pathophysiology: Assessment and Treatment in Male Infertility. National Library of Medicine. URL. Accessed August 1, 2022.
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